fredag den 5. juni 2015

All accidents are prevebtable !

The question of course is: Are they indeed?  Why then don’t we see this happening in our everyday observations?  Just check the news or your company’s incident statistics.  Why are we still having accidents after almost a century of more or less serious safety management efforts, scientific and technical progress and increased societal demands through better standards and regulations?
 
If the presumption that all accidents are preventable would be true, aren’t we trying hard enough after all?  Or can’t we after all?  Or is this (as some cynical folk think) just a phrase that is used to justify so-called ‘Zero Harm’ goals?  The latter thought isn’t so absurd, by the way, because ‘zero’ is only achievable if indeed all accidents can be prevented.
 
Some may argue that some things cannot be prevented because if someone’s out to get you, they surely will.  Safety professionals have thought long about this and that’s probably one reason that ‘Acts of God’ usually are excluded from accidents and that most ‘safety definitions’ of accidents (check a popular one on Wikipedia) describe them as “unintended” events thus excluding terrorism, sabotage and the like and sending these events over to the realm of security. After some thoughts I’ve come to the conclusion that the often heard manta of “All Accidents Are Preventable” is true only if we add a couple of words.  Let’s discuss some good candidates:
 

All Accidents Are Preventable……In Theory
What theory that would be, I’m actually quite unsure about.  But some safety academics seem to think so.  By the way, the denominator “academics” here is meant in the meaning of “safety professionals living in ivory towers with little or no relation to reality”, not in the ordinary dictionary meaning of people involved in higher education or research of safety. Actually, the term theory is not defined as “a contemplative and rational type of abstract or generalizing thinking, or the results of such thinking” (Wikipedia definition) either. Nor is it a “generalized explanations of how nature works”.  Rather we use ‘theory’ here as the opposite of ‘practice’ and one might even see it as a synonym for ‘dream’, ‘vision’ or even ‘delusion’.
 
 
…In Hindsight
In real life and at the sharp end decisions are usually made under difficult circumstances, a lot of uncertainty, limited knowledge and time pressure.  Mostly we manage very well, but sometimes the outcome of our decisions isn’t quite what we expected or hoped for.  We did our best, but things went otherwise because we did the wrong thing regarding the circumstances of which we hadn’t the full overview at the time.  As a result of all of this an accident happens. These difficulties and limitations are significantly absent after the fact.  Then one suddenly has full overview of circumstances, there is plenty of time to reflect and contemplate, gather additional information (preferably to confirm a hypothesis) and best of all: outcomes of the decisions made are known, so no uncertainty at all!
 
We do have blind spots in real life, and so do organizations.  In hindsight we seemingly don’t suffer from this.  Of course there are still blind spots but at least we now see the things that went wrong, which are the things that we should have seen before, according to everyone pointing their fingers afterwards.
 
 
…Given unlimited knowledge, resources, perfect prediction (and quite some luck)
This is the best of the contextual candidates.  If we didn’t have those annoying limitations discussed before. If we just knew everything with an enormous deal of certainty and precision, including the results of our actions and decisions.  If we had unlimited resources to remove all hazards.  Truly, no accident would happen. Ever. Or rather never.
 
But, how realistic is that scenario?  People have limitations and resources (time, money, etc.) yet must face exactly the same problem.  Anyone who has experienced otherwise should really share his experience with us mere mortals.  It must have been a really boring experience by the way.  So where does that leave us who are living out there in the real world? - Let’s just face it, we cannot prevent everything.  Let’s just be very realistic about that.  We don’t even want to prevent absolutely everything – some things we just can live with (the proverbial finger cuts when filling paper into the printer being just one example).  This is clearly one reason that in many safety and OHS legislations the ‘reasonably’ criterion is found. Mind you, this is not an argument out of fatalism! We cannot prevent everything, but that doesn’t take away the responsibility to try as hard as we can within reasonable boundaries. Allow me to quote Prof. James Reason from the conclusion of his fine 2008 book “The Human Contribution”:
 
Safety is a guerrilla war that you will probably lose (since entropy gets us all in the end), but you can still do the best you can.
 
Let’s take these wise words at heart and get on it.  Maybe we cannot prevent all accidents, but we can prevent a substantial part if we want and work systematically and structurally.  Hopefully we’ll succeed in preventing the most important ones. Good luck!

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